Therapeutic options for capillary papillary hemangiomas

Ophthalmology. 2000 Jan;107(1):48-54. doi: 10.1016/s0161-6420(99)00018-4.

Abstract

Purpose: To describe the results and therapeutic complications of treatment of papillary capillary hemangiomas over the last 13 years.

Design: Retrospective, noncomparative, interventional case series.

Participants: Five cases of unilateral capillary papillary hemangiomas were reviewed. Three patients had von Hippel-Lindau disease, and two had no associated familial or systemic disease.

Methods: Two patients were treated with argon green laser, one patient received argon green and diode photocoagulation, and two patients underwent argon green photocoagulation and diode transpupillary thermotherapy (TTT); two eyes also underwent vitreoretinal surgery. Follow-up ranged from 1 to 13 years.

Main outcome measures: The presence of exudative retinal detachment associated with the activity of the hemangioma and the visual acuity were the two main parameters.

Results: Prompt argon green laser treatment was the most effective therapy; -II was ineffective. Vitreoretinal surgery, transscleral drainage, and argon endolaser photocoagulation in one case resolved bullous retinal detachment secondary to tumor exudation. Pretreatment visual acuity (VA) levels ranged from 20/25 to counting fingers; posttreatment VA levels ranged from 20/25 to light perception.

Conclusions: If left untreated, papillary hemangiomas may evolve to exudative retinal detachment and marked VA decreases. Although we have not established an ideal therapy, we recommend appropriate treatment on diagnosis. Close follow-up and multiple treatments with argon laser are likely the best therapeutic course.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Hemangioma, Capillary / complications
  • Hemangioma, Capillary / diagnosis
  • Hemangioma, Capillary / therapy*
  • Humans
  • Hyperthermia, Induced*
  • Laser Coagulation*
  • Male
  • Middle Aged
  • Retinal Detachment / etiology
  • Retinal Neoplasms / complications
  • Retinal Neoplasms / diagnosis
  • Retinal Neoplasms / therapy*
  • Retinal Vessels / pathology
  • Retrospective Studies
  • Visual Acuity
  • Vitrectomy*
  • von Hippel-Lindau Disease / complications